In a variety of medical procedures, catheters are percutaneously implanted, i.e., through a patient's skin, to provide long term access to interior body sites; e.g., blood vessels and organs. Unless adequate precautions are taken, infections and inflammation can readily occur at the catheter entry site. To mitigate such problems, a tissue integrating cuff is sometimes attached to the catheter and placed under the patient's skin to resist infection. Although such a cuff can reduce the likelihood of infection, once ingrown its presence increases the difficulty of removing and/or repositioning an implanted catheter. More particularly, it is not uncommon for an implanted catheter to become damaged, e.g., clogged or kinked, over an extended period of use thus necessitating catheter removal and/or replacement. When this occurs, the cuff must be dissected thereby complicating and prolonging the surgical procedure.
The aforementioned parent application Ser. No. 11/708,445 describes a medical apparatus and method which enables an elongate conduit, e.g., a catheter or cable, to be percutaneously implanted in a manner which allows the conduit to be readily positioned, repositioned, and replaced. A preferred embodiment described in said parent application includes a sleeve carrying a tissue integrating porous layer proximate to the sleeve distal end. The sleeve distal end is intended for insertion through a skin incision to subcutaneously locate the porous layer in contact with the patient's dermis for promoting soft tissue ingrowth. Such tissue ingrowth functions to anchor the sleeve and create an infection resistant barrier. The preferred embodiment described in said parent application preferably also includes a protective sheath overlaying the porous layer to avoid injuring incision adjacent tissue as the sleeve distal end is inserted through the incision. The sheath is removed from the sleeve by the physician after the porous layer has passed through the incision.
The aforementioned parent application Ser. No. 12/287,130 describes an apparatus and method for implanting a medical device through an incision which is intentionally undersized relative to the lateral dimension, i.e., width or diameter, of the device porous layer to enhance cell proliferation and healing.